Posts Tagged ‘health’

Coping with being a longterm caregiver can be a costly affair, physically and emotionally. Just ask anyone who has ever done it.

However, there are ways to make it less costly, and that’s what the Rosalyn Carter Institute for Caregiving is all about.

Gayle Alston, MS, Director the RCI Training Center of Excellence, explained the program recently at the Unitarian Universalist Fellowship of Columbus, Georgia.

There are a number of ways to do that. Probably topping the list is to remember that if you don’t take care of yourself, you won’t be able to take care of someone else.

Taking care of yourself includes making sure you have some time for yourself. To get that time you’re going to need help from others. If a friend offers to come over and sit a while so you can get away from the house for a while, don’t be shy about accepting that offer. If they are true friends they will mean it when they say it.

If you want to learn more about this you can attend Caring for You, Caring for Me training sessions offered in October at the UU Fellowship of Columbus. It will be led by Maureen and Jim Humphies who recently participated in a Trainer workshop at the Rosalyn Carter Institute for Caregiving. Maureen has been involved with the RCI since 1990.

If you would like more information you can call the Humphries at (706) 505-8223, or email maureenhumphries1946@gmail.com or humfriesjim43@gmail.com.

Maybe I should call it a fall in the park. Thankfully, a compassionate lady and her daughter helped me get up and walk me to my car after I fell while walking in Cooper Creek Park. I spent five days at St. Francis Hospital and will go to my cardiologist for more tests to determine what caused me to black out. I’m sure age had something to do with it. Thanks to folks at St. Francis, my doctors, and family and friends for their loving support.

You could say that maybe if we had thousands of philanthropic physicians like Grant Scarborough and those who support him, our country could provide affordable health care for all. Maybe we wouldn’t need single-payer or Medicare for all to solve the crisis of exploding costs and millions without healthcare insurance. Of course, that alone would not solve the problem.

Dr. Scarborough is Founder and Executive Director of Mercy Med. It’s a religiously inspired non-profit organization that provides healthcare for the poor. He and his paramedics treat anyone who walks in the door of his clinic in the former CB&T banch building on 2nd Avenue whether they have insurance or not. Speaking to the Rotary Club of Columbus, he said, “individuals come in and pay an average of 28 dollars and get over 300 dollars of health care. It’s a great deal.” If someone comes in who is making more than $45,000 a year, he’ll charge them 45 dollars for an office visit. What if you are homeless and can’t pay? No one gets turned away.

It’s also a great deal for hospitals with emergency rooms, because clinics like his save them millions of dollars. Many of those who use clinics like his would simply go to the hospital emergency rooms for their treatment if those clinics did not exists.

He is motivated by the lesson of the Good Samaritan parable that the Bible says was told by Jesus Christ. The Good Samaritan stopped to help the man who had been beaten and robbed. Took him to an inn and gave the innkeeper money to care for him, and said he would back and give the innkeeper more if more was needed. And Dr. Scarborough invites us to join him in his quest. He said, “I encourage you to get involved with us or with another ministry, or with another country, and consider, and then be kind to the poor by loving your neighbor.”

I said earlier that having thousands of doctors like Dr. Scarborough might solve our healthcare crisis. However, physicians ares only part of the picture. There are other elements involved, things like hospitals, labs, diagnostic centers, and pharmaceutical and insurance companies.

I asked the nurse assigned to me, “How many doctors are on duty tonight?” She replied , “Two.” That confirmed my suspicion that The Medical Center’s Emergency and Trauma Center was understaffed that night, Sunday, April 3, 2011. That suspicion had been formed when another nurse, the one assigned to triage, told me that wait times would probably be up to seven hours for some of the many people sitting in the ETC waiting room, and the average wait would be about five hours. Because I had a head wound and was on a blood thinner which could have increased the chances of internal bleeding, I didn’t have to wait that long. I got to see a doctor in about two hours from the time I signed in.

So, my impression was the ETC was like emergency rooms all over the country, overburdened and understaffed, but was it? In my opinion, that night, Sunday, April 3, 2011, it was. However, it was not a normal night. I learned just how abnormal it was when I posed a few questions to Marion Scott, who is Director of Communications for the Columbus Regional Medical System. I decided to let her speak for herself unedited. This is what she wrote to me.

On the night you were treated, staffing in the ETC was at the “best practice” standard as set by the national Emergency Nurses Association. Staffing ratio is one nurse to four patients. There were two emergency physicians in the ETC that evening; again, an appropriate staffing level under routine conditions. Residents from our teaching program do not routinely work in ETC. They do report to the ETC for duty when we call “trauma,” a designation indicating extraordinary and severe patient volume that increases staffing across clinical and non-clinical support areas. We typically have one to three trauma cases in a 24-hour period. In the 24-hour period during which you were treated, we had 20 trauma cases – seven to ten times the normal trauma volume. You also asked about the number of patients treated in the Emergency and Trauma Center who cannot pay for care. For our last full fiscal year, which ended June 30, 2010, 86 percent of the total patient encounters through the ETC were uninsured and 33 percent resulted in uncompensated care. The Medical Center’s total uncompensated care for last fiscal year was just over $32 million. As you and I have discussed, the greater issue related to emergency care is the number of people who use an emergency room for minor illnesses and injuries and for primary care. Approximately 40 percent of the patients treated in The Medical Center’s ETC could have been treated in a more appropriate setting, such as their physician’s office or an urgent care center. The result of inappropriate use of an emergency room is overcrowded emergency rooms with long waits, inefficient use of hospital resources and higher costs for patients and insurers. Also, many people treated in an emergency room for minor illnesses and injuries do not have a physician, or “medical home.” It is so important to have a physician with whom you can establish an ongoing relationship and who will understand your health and medical needs and provide continuity of care. There are no easy answers or quick fixes to these serious problems. We can address the issues through education, communication, and services to assist the uninsured in finding programs that might help them and to assist people without a physician in finding a medical home.

Doctor in St. Augustine, Texas giving Typhoid Innoculation in 1944, Photograph by John Vachon for the United States Farm Secuirty Administration

Recently, I went to Fort Lauderdale to see my grand-nephew Gibson Gray graduate from med school. It was very satisfying to see him get that diploma, and the family had a great time celebrating the event with a Ft. Lauderdale vacation, but the event also brought home the fact that he is going into a profession that is in trouble. That’s because healthcare in the United States is in trouble.

Americans are not satisfied with the state of healthcare; they list it right up there with the economy when asked about what concerns them most at this juncture in history. The keynote speaker at Gibson’s graduation took the issue head on and got a lot of applause for eome of the things she said, but she also got some pregnant silences for some of the other things. The subject is, as you know, very controversial.

Monday, I will be getting into the issues that she raised. Join me, and please don’t hesitate to give me your opinions. Just click the “comment” button and tell us how you feel.

Our lives are determined by conversations, what people say to one another, and the choices people make when deciding on how to respond to another person’s words. Dr. Brian Wong of the Bedside Project, brought that home during a talk to to members of the Columbus Rotary Club. (His appearance was sponsored by St. Francis Hospital.) It’s the sort of thing that he tells physicians when he is coaching them on how to improve their bedside manner by proper communications.

He used film clips of the movie Gettysburg to make his point. Colonel Joshua Chamberlain was faced with dealing with 120 members of the 20th Maine regiment who had mutinied and refused to fight at Gettysburg. Wong played clips from the movie showing how Chamberlain responded to remarks made by angered mutineers. He would stop the film and ask the Rotarians to turn to one another and say what they would have said if they had been the colonel, then he played Colonel Chamberlains response, which was usually the opposite to the first blush immediate reactions by the Rotarians.

Turns out that Chamberlain won the men over by the way he handled the situation. The picked up their muskets and join the famous bayonet charge that defeated Southern troops at Little Round Top. He did it, according to Dr. Wong by expertly using the space between stimulus and response. In other words when someone says something to you, that is the stimulus, and the space between that and your response can make a lot of difference.

Instead of reacting immediately to disrespectful and insubordinate remarks by a spokesman for the mutineers, he would pause before he spoke, and then say the opposite of what an immediate, also angry would have been. It disarmed the mutineers, and he gave a speech – maybe the Hollywood version in the movie had some truth to it, though no one seems to know how much – that inspired all but a few of the men to pick up their muskets again and join in the fight.

The lesson of Dr. Wong, “Use that space before you respond, and, quite often, it will be the opposite of what you would have said if you had not used it, and the outcome can be much better.” This is the sort of thing he teaches doctors in inspiring them to improve their relationships with their patients. I guess it boils down to “look before you leap” and “think before you speak,” if we put it in terms of well-worn proverbs.

When I arrived at my new dermatoligist’s office this morning, I couldn’t beleive the number of cars in the parking lot. I knew there was only one doctor in the building. I thought, oh no, he’s one of those doctors that schedules everybody to come it at the same time and then treats you in the order of your arrival. That, from past experience, can run into more than an hour’s wait.

When I signed in, I asked the receptionist if that was his procedure. She said that it wasn’t, but that he was running behind. There have been very few times when I went for an office visit that my doctor wasn’t “running behind.”

So, I found a seat in the crowded waiting room and scanned the room for magazines. It’s always fun to see if one doctor has magazines that are older than another one. I’ve found some that were more than a year old. But, it didn’t matter. There weren’t any. That meant my only choice to kill time was to watch Fox News. It’s interesting that doctors all seem to want their patients to watch Fox News, especially since it can drive up ones blood pressure.

The TV sound was so low I could hardly understand what anyone was saying. I reflect that’s really not so bad because Fox’s obvious bias can hack me off.

No magazines. Fox News. What I am going to do? Well, it turned out that I didn’t need to worry because a nice lady came over to say hello. I figured it was another person who remembered me from all those years I anchored TV newscasts, but it wasn’t. It was the lovely wife of Rev. Jimmy Cook. They came over and sat with me and we had a great visit.

Jimmy, who was pastor of the Morningside Baptist Church, and I have something in common. He started out his young life on radio just a few years before I did the same thing. He stopped a long time before I, deciding in 1954 that he had rather be a preacher instead. I remembered him as Country Boy on WGBA Radio. He talked in a wild, over-the-top hick accent on that show and played country music. He built quite a following.

He started out as manager of the station in 1949. I started in radio in 1948 at WDAK as a 17-year-old announcer. I was still in high school. WGBA was then owned by the Page Corporation, owner of the Columbus-Ledger Enquirer at the time. At first it was an FM station. That was when hardly anybody had FM radios. Everyone was still listenting to AM stations then. After a while, he switched from manager to air personality and said, “That worked better for me.”

Well, Jimmy and Mrs. Cook and I started having a grand old time strolling down memory lane as we discussed the radio era. A couple of other old geezers who recognized Jimmy and me, and who were evesdropping on the conversation, decided they couldn’t restrain themselves any more and joined in. They, too, had their memories of the “good old days.”

So what sarted out to be a boring doctor’s office wait turned into just the opposite. We all had a great time and even though my wait to get in to see my doctor was about an hour, I didn’t mind at all because it was a fun hour.

However, you can’t always depend on running into great people like Rev. Jimmy and Mrs. Cook. So maybe doctors should keep some of those ancient magazines availble for those of us who had rather read a year-old copy of Time, Newsweek, or U.S. News and World Report than watch Fox News.